Multisociety consensus guideline sets 32 imaging recommendations for osteosarcoma and Ewing sarcoma, but evidence gaps remain

A new European guideline, developed by 36 multidisciplinary experts, provides 32 consensus-based imaging recommendations for osteosarcoma and Ewing sarcoma. Evidence remains insufficient to recommend optimal modalities for bone metastases, response prediction, or surveillance fr…

• Systematic review of 2026 studies yielded only 13 eligible, marked by heterogeneity in diagnoses and protocols; guideline formulated by FOSTER, Euro Ewing, ESPR, and EANM.
• No metabolic imaging indices or MRI parameters consistently predicted treatment response or survival in the reviewed evidence.
• Key limitation: heavy reliance on expert opinion due to critical evidence gaps; prospective, harmonised imaging studies are urgently needed.

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